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Inside the Lines

Module 4: Scope of Practice and Professional Limits · Lesson 1 of 3

11 min Back to module

Story opener

A participant says, quietly, at the end of a session about bus routes: 'Some days I don't see the point of any of it.' Your next sixty seconds matter more than the entire lesson plan you brought.

Learning objectives

  • Be able to reinforce, prepare, and route clinical questions; never advise
  • Be able to same-day routing is part of scope discipline

Lesson

Skills teaching, coaching, support, coordination, and documentation are yours.

You assess functioning, teach skills, structure practice, arrange supports, and document. You do not diagnose, provide psychotherapy, adjust medication, or offer medical advice. You may reinforce what the prescriber said and help the participant prepare questions for their next appointment.

Scope questions usually arrive disguised as kindness: 'Just tell me whether I should stop taking it.' The respectful answer names your role and routes the question to the right person the same day.

Maryland guidance & authority labels

Every statement below is labeled so you know what is binding regulation, what is only proposed, what is professional guidance, and what is our house standard.

  • COMAR — current

    Rehabilitation specialists do not diagnose, provide psychotherapy, or make medication recommendations. Clinical questions route to the licensed clinician the same day.

  • Internal best practice

    Same-day routing means a documented contact attempt, not a note to yourself to follow up tomorrow.

Common mistakes

  • Offering clinical interpretation to be helpful.

    Do this instead — Reflect, assess safety, and route. Helpful and in-scope are the same thing here.

Practical examples

Practical example

Instead of 'met with participant to discuss goals,' write: 'Reviewed the transportation objective; participant identified the #22 route unassisted and named one back-up plan. Verbal prompt needed once. Next session: practice the transfer at Mondawmin.'

Key takeaways

  • Reinforce, prepare, and route clinical questions; never advise
  • Same-day routing is part of scope discipline

Reflection prompts

  1. 1Which part of this lesson describes something you are already doing differently in practice?
  2. 2What would an auditor see in your last five notes that contradicts this standard?

Bring your answers to supervision — the case-study workspace in this module saves written notes to your account.

Knowledge check

4 questions drawn from a bank of 6 · 75% to pass · instant feedback on every answer

1. A colleague does this: Offering clinical interpretation to be helpful. What should they do instead?

2. How should you treat this statement? "Same-day routing means a documented contact attempt, not a note to yourself to follow up tomorrow."

3. Which statement is a key takeaway from "Inside the Lines"?

4. Which additional point does "Inside the Lines" emphasize?